阿尔玛阿塔事件发生30年后:各国的初级医疗保健是否有所成效?
Jon Rohde1, Simon Cousens, Mickey Chopra
1Management Sciences for Health, Boston, MA, USA; James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.
Lancet (London, England)
|September 16, 2008
概括
各国可以在初级医疗保健方面取得重大进展,即使资源有限. 关键的教训包括分阶段实施,强有力的地区管理,以及投资于卫生工作者,以实现全民健康覆盖.
科学领域:
- 全球健康 全球健康
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
背景情况:
- "阿尔马塔宣言"强调初级卫生保健 (PHC) 是实现"全民健康"的关键.
- 评估PHC进展需要分析相对于社会经济因素和具体干预措施的健康结果.
研究的目的:
- 自阿尔马塔会议以来,评估不同国家的初级医疗保健 (PHC) 进展情况.
- 确定有助于成功实施医疗卫生保健和减少低收入和中等收入国家儿童死亡率的因素.
主要方法:
- 分析了与国民收入和艾滋病毒流行率相比的预期寿命,以将国家分类为过度或低绩效的国家.
- 专注于30个高绩效的低收入和中等收入国家,以减少5岁以下的死亡率.
- 检查了这些国家的医疗保健服务覆盖范围,公平性和非医疗部门的行动.
主要成果:
- 30个国家显示,儿童死亡率显著降低,许多国家扩大了选择性PHC (例如免疫接种).
- 这些国家中有14个国家取得了全面的医疗保健,其特点是高技能分娩率.
- 泰国在普遍疫苗接种和熟练分娩,低不平等和高儿童死亡率下降方面取得了卓越的进展.
结论:
- 成功的PHC需要一个国家一致的,分阶段的战略与利益相关者的承诺.
- 有效的地区管理系统和对初级医疗保健推广工作人员的持续投资至关重要.
- 进一步分析对于指导投资和加速实现千年发展目标和全民健康覆盖的进展至关重要.
相关概念视频
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01:21Tertiary Healthcare System
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